Analysis of prevalence of HIV-1 drug resistance in primary infections in the United Kingdom
BMJ 2001; 322 doi: https://doi.org/10.1136/bmj.322.7294.1087 (Published 05 May 2001) Cite this as: BMJ 2001;322:1087
- UK Collaborative Group on Monitoring the Transmission of HIV Drug Resistance. (d.pillay{at}bham.ac.uk)
- Correspondence to: D Pillay, PHLS Antiviral Susceptibility Reference Unit, Division of Immunity and Infection, University of Birmingham Medical School, Edgbaston, Birmingham B15 2TT
- Accepted 17 January 2001
Abstract
Objectives: To identify changes since 1994 in the prevalence of resistance to anti-HIV drugs in primary HIV-1 infections in the United Kingdom.
Design: Retrospective and prospective assessment of viruses obtained from people recently infected with HIV.
Setting: Multiple centres (patients enrolled in the UK register of seroconverters) and a single large HIV clinic (active case ascertainment).
Participants: 69 patients infected with HIV between June 1994 and August 2000.
Main outcome measures: Prevalence of key mutations associated with drug resistance in the reverse transcriptase and protease genes of HIV-1, by year of infection.
Results: Between June 1994 and August 2000, 10 (14%) of 69 newly infected patients had one or more key HIV-1 mutations associated with drug resistance. The risk of being infected with drug resistant virus increased over time (adjusted relative risk per year 1.74 (95% confidence interval 0.93 to 3.27), P=0.06). The estimated prevalence of drug resistance in those infected in 2000 was 27% (12% to 48%).
Conclusions: Transmission of drug resistant HIV-1 in the United Kingdom seems to be increasing. New approaches to encourage safer sexual behaviour in all sectors of the population are urgently needed.
What is already known on this topic
What is already known on this topic The emergence of HIV drug resistance in patients receiving antiretroviral therapy is common
Transmission of virus variants resistant to anti-HIV drugs has been documented
What this paper adds
What this paper adds The prevalence of transmitted HIV drug resistance in the United Kingdom is increasing, exceeding 20% in 2000
New approaches to encourage safer sexual behaviour are urgently needed
Footnotes
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Funding This work is funded by the Public Health Laboratory Service (PHLS) and the Medical Research Council (MRC). The UK Collaborative Group on Monitoring the Transmission of HIV Drug Resistance is a collaboration between the PHLS Antiviral Susceptibility Reference Unit and the UK Register of HIV Seroconverters. The UK register is a collaboration between the MRC Clinical Trials Unit and the PHLS Communicable Disease Surveillance Centre, Department of Primary Care and Population Sciences and Department of Sexually Transmitted Diseases, Royal Free and University College Medical School.
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Competing interests Work in DP's laboratory has been supported by research and educational grants from a number of pharmaceutical companies, and DP is an occasional adviser to these companies. GD, DC, and MF have received financial support to attend conferences from various pharmaceutical companies which manufacture antiretroviral agents. DC and MF have also received funding for consultancy work for pharmaceutical companies.
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Full details of all authors and their affiliations are on the BMJ's website
- Accepted 17 January 2001